Overexpression of vascular endothelial growth factor-C correlates with lymph node micrometastasis in submucosal esophageal cancer |
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Authors: | Masataka Matsumoto MD PhD Shoji Natsugoe MD PhD Hiroshi Okumura MD PhD Hideo Arima MD Shigehiro Yanagita MD Yasuto Uchikado MD PhD Naoya Yokomakura MD Tetsuro Setoyama MD Sumiya Ishigami MD PhD Sonshin Takao MD PhD Takashi Aikou MD PhD |
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Institution: | (1) Department of Surgical Oncology and Digestive Surgery, Field of Oncology, Course of Advanced Therapeutics, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, 890-8520 Kagoshima, Japan |
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Abstract: | Lymph node metastasis, including lymph node micrometastasis (LMM), is one of the most important prognostic factors in esophageal
squamous cell carcinoma (ESCC). Vascular endothelial growth factor C (VEGF-C) plays a key role in the process of lymphangiogenesis.
We examined VEGF-C expression and tumor microvessel density of the primary tumors in ESCC and analyzed relationships between
VEGF-C expression and clinicopathologic findings including LMM in submucosal ESCC. The subjects were 87 patients with submucosal
ESCC. Immunohistochemical staining of VEGF-C and CD34 was performed with primary tumors, and staining of cytokeratin was performed
with dissected lymph nodes. Microvessel density was calculated from CD34 expression, and LMM was detected by cytokeratin staining.
VEGF-C overexpression significantly correlated with depth of tumor invasion, lymphatic invasion, and lymph node metastasis
(P<0.05, P<0.0001, and P<0.0001, respectively). High microvessel density also correlated with lymphatic invasion and lymph node metastasis (P<0.005 and P<0.05, respectively). LMM was detected in 8 cases and 14 lymph nodes by cytokeratin staining. VEGF-C overexpression and high
microvessel density were found in tumors with lymph node metastasis and/or LMM, compared with tumors without nodal metastasis
or LMM (P<0.0001 and P<0.01, respectively). The present findings indicate that in ESCC with submucosal invasion, VEGF-C overexpression of the primary
tumor is a strong high risk factor for lymph node metastasis, including LMM.
Supported in Grant No. 17390373 part by grants-in-aid for scientific research from the Ministry of Education, Science, Sports
and Culture, Japan. (Shoji Natsugoe, M.D., Ph.D.) |
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Keywords: | VEGF-C microvessel density lymph node micrometastasis esophageal cancer |
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